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General NPI Number Information
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NPI Number | 1013749670
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Entity Type | Organization
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Legal Business Name | UROLOGEX LLC
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Dates
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Enumeration Date | 08/14/2024
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 114 W LOSOYA ST
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City | DEL RIO
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State | TX
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Zip | 78840-5858
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Country | US
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Telephone | 830-488-6020
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Fax | 830-488-6030
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Provider Business Mailing Address
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Address Line | 196 DIEGO LOOP RD
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City | DEL RIO
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State | TX
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Zip | 78840-2463
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | VANESSA LYNN ORTIZ-AVALOS
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Credential |
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Telephone | 830-265-8342
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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